Functional Subgroup Research Articles

Data-driven design of high-curie temperature full-heusler alloys for spintronic applications

In this study, we employ density functional theory (DFT) and subgroup discovery (SGD) to explore the structural and magnetic properties of full cubic Heusler compounds, with a particular emphasis on their Curie temperatures (Tc) and magnetic stability. Our comprehensive examination of 2903 structures across both L21 and Xa phases identifies configurations that exhibit both structural stability and superior magnetic properties. Notable among these, compounds such as Co2MnSi, Co2CrGe, and Cr2VGe exhibit remarkable magnetic stability, maintaining their ferromagnetic properties well above room temperature. Co2MnSi displays a substantial magnetic moment of 5.00 μB and maintains its ferromagnetic properties up to a Curie temperature of 937 K, underscoring its suitability for high-temperature applications. Similarly, Co2CrGe, with a magnetic moment of 4.00 μB, transitions to a paramagnetic state at a higher temperature of 952 K, demonstrating enhanced thermal durability. Moreover, Cr2VGe, notable for its robust magnetic moment of 2.81 μB, retains its ferromagnetic characteristics until an exceptional 2412 K, making it extremely valuable for thermally intensive environments. These findings underscore the potential of these materials in developing durable and efficient spintronic devices that operate under extreme thermal conditions. By mapping the interplay between electronic structure and magnetic properties, our study provides a predictive framework for optimizing the performance of spintronic materials.

Daratumumab in transplant-eligible patients with newly diagnosed multiple myeloma: final analysis of clinically relevant subgroups in GRIFFIN

The randomized, phase 2 GRIFFIN study (NCT02874742) evaluated daratumumab plus lenalidomide/bortezomib/dexamethasone (D-RVd) in transplant-eligible newly diagnosed multiple myeloma (NDMM). We present final post hoc analyses (median follow-up, 49.6 months) of clinically relevant subgroups, including patients with high-risk cytogenetic abnormalities (HRCAs) per revised definition (del[17p], t[4;14], t[14;16], t[14;20], and/or gain/amp[1q21]). Patients received 4 induction cycles (D-RVd/RVd), high-dose therapy/transplant, 2 consolidation cycles (D-RVd/RVd), and lenalidomide±daratumumab maintenance (≤ 2 years). Minimal residual disease–negativity (10−5) rates were higher for D-RVd versus RVd in patients ≥ 65 years (67.9% vs 17.9%), with HRCAs (54.8% vs 32.4%), and with gain/amp(1q21) (61.8% vs 28.6%). D-RVd showed a trend toward improved progression-free survival versus RVd (hazard ratio [95% confidence interval]) in patients ≥ 65 years (0.29 [0.06–1.48]), with HRCAs (0.38 [0.14–1.01]), and with gain/amp(1q21) (0.42 [0.14–1.27]). In the functional high-risk subgroup (not MRD negative at the end of consolidation), the hazard ratio was 0.82 (0.35–1.89). Among patients ≥ 65 years, grade 3/4 treatment-emergent adverse event (TEAE) rates were higher for D-RVd versus RVd (88.9% vs 77.8%), as were TEAEs leading to discontinuation of ≥ 1 treatment component (37.0% vs 25.9%). One D-RVd patient died due to an unrelated TEAE. These results support the addition of daratumumab to RVd in transplant-eligible patients with high-risk NDMM.Video -YjyZJrsb3fs1sAVfK2kfK

Single-cell transcriptomics reveals antigen-presenting capacity and therapeutic resistance potential of immunomodulatory endothelial cells in colorectal cancer.

The heterogeneity of tumor endothelial cells (TECs) hinders the efficacy of antiangiogenic therapies (AATs). Only a small percentage of angiogenic TECs are considered effective targets for AATs. Immunomodulatory ECs (IMECs), as a newly focused functional subgroup of endothelial cells (ECs), are being evaluated for their ability to regulate tumor immune balance and influence existing AATs. Based on single-cell transcriptome data from colorectal cancer in a publicly available database, we conducted a wide array of bioinformatic approaches to study EC subsets that meet the IMECs definition. Our investigation encompassed the gene expression signatures of these subsets, cellular composition differences, cell-cell interactions. Two subsets that meet the IMECs definition were found in tumors and para-cancerous tissues. Combined with the results of gene ontological analysis and interaction with CD4+ T cells, we found that IMECs can present MHC-II antigens to mature CD4+ T cells. There were differences in the level of interaction between IMECs and different types of mature CD4+ T cell subsets. In addition, IMEC subsets had different expression levels of angiogenesis related genes. The angiogenesis score of IMECs decreased after patients received immunotherapy. IMEC subsets do not depend on a single proangiogenic receptor and are involved in regulating angiogenesis, which may reduce the efficacy of AATs. The adverse effects of specific IMEC subsets on AATs were validated in the RNA-seq dataset of the bevacizumab treatment group. Our study suggests the potential MHC-II antigen presentation capacity of IMECs and the enhanced angiogenesis characteristics within tumors. The function of IMECs in the vascular network may have a potentially adverse effect on AATs. Controlling the functional properties of IMECs may be a new angle for tumor therapy.

Isatuximab Rescue for Inadequate Response to Lenalidomide and Dexamethasone in Transplant Ineligible Patients with Newly Diagnosed Multiple Myeloma: Primary Analysis of the Phase II Iril Study of the Australian Myeloma Research Consortium (AMaRC 18-02)

Background: A significant proportion of transplant ineligible, treatment-naïve multiple myeloma (NDMM, TNE) patients (pts) do not proceed to second line anti-MM therapy. Given depth of response to initial therapy correlates with overall survival (OS), a deep remission should be the target for this often elderly and frail cohort of pts. Additionally, current risk-stratification models utilizing predictive biomarkers, cytogenetics, FISH, and molecular profile cannot reliably identify patients with functional high-risk MM who respond sub optimally [i.e., < partial response (PR)]to standard first line therapy. IRIL is a phase II, multicentre, response-adapted study examining treatment rescue/intensification with isatuximab (Isa), an anti-CD38 monoclonal antibody, for functional high-risk pts, defined as those not achieving pre-defined target responses to lenalidomide and dexamethasone (Rd). Method: TNE NDMM pts meeting IMWG criteria for treatment were eligible for enrolment. Pts commenced treatment with lenalidomide [R; 25mg D1-D21 of a 28-day cycle (c)] and dexamethasone [d; 40mg (20mg for those aged ³75 years) PO weekly]. Isa (10mg/kg IV weekly for c1, then fortnightly) was added for failure to achieve pre-defined target responses [³PR after 4c, ³VGPR after 6c, or ³CR after 9c of Rd] or progressive disease (PD) within the first 9c Rd and was continued until PD or consent withdrawal. The primary endpoint was the achievement of PR or better after an additional 6c of Isa-Rd in pts who progressed during the first 4c of Rd or did not achieve a PR after 4c of Rd (i.e., the functional high-risk subgroup). A dual-criteria, Bayesian Proof-of-Concept (PoC) design was implemented requiring an observed rate of PR (or better) after 6c Isa-Rd of ≥ 50% with a posterior probability that the true rate exceeds 37.7% of >95%. The protocol allowed the trial management committee (TMC) to halt accrual at the first demonstration of PoC. The secondary endpoints were achievement of VGPR or CR after an additional 6c Isa-Rd in pts failing to meet these milestones after 6 or 9c Rd, progression free survival (PFS), OS and safety. This is a report of a per-protocol specified interim analysis of the primary endpoint. Results: From June 2019 until April 2023, 68 pts [52% male, median age 78.2 years (range 65.5-91.9), R-ISS Stage I (n=11), Stage II (n=37), Stage III (n=10)] were enrolled (67 commenced treatment with Rd). At the first interim analysis, both Bayesian PoC criteria were met with the observed PR rate after up to 6 additional cycles of Isa-Rd of 73.3% with a posterior probability that the true rate exceeded 37.7%, greater than 95% (Table 1). Given PoC was demonstrated and the SARS-CoV-2 pandemic-related slower than expected accrual, the TMC terminated study recruitment. At the most recent sweep in June 2023 (Figure 1), 14/15 rescued pts have achieved a PR or better (9/15 VGPR or CR), 4 deaths have been reported (1 each of disease-related, cardiac event, trauma, cause unknown) while 8/15 pts remain on treatment. With an estimated median potential follow-up of 28 months, a preliminary estimate of PFS at 24-months is 73.3% (median PFS not reached). The safety profile for the combination Isa-Rd is similar to previously reported. 14/15 pts had any grade (Gr) adverse event (AE) reported, while 73% pts had at least 1 ³ Gr 3 AE (10 pts with Gr 3, 1 pt with Gr 4). The most common ³ Gr 3 AE were neutropenia (40%), fever (13.3%), back pain (13.3%) and mood disturbance (13.3%). Conclusion: A response-adapted approach to treatment of TNE NDMM pts with Isa rescue upon disease progression or failure to meet a target response to Rd is safe and effective. Isa rescue improves depth of response after 6 additional cycles of therapy in 73% of functionally high-risk patients. The study was closed to recruitment early due to demonstration of PoC of a response-adapted treatment strategy. There were no new safety signals observed from the Isa-Rd combination. Reports on secondary endpoints will be presented, 12 months following the last Isa rescued patient's 6 th cycle of IsaRd. This study is supported by BMS/Celgene (funding), Sanofi/Genzyme (provision of Isatuximab), The Victorian Cancer Agency (funding) and the Victorian Epigenetics Group (funding).

Mid-Term Clinical and Radiological Results at a Tertiary Care Hospital in Türkiye: Is Residual Varus Really Important After Mechanically-Aligned Total Knee Arthroplasty?

Traditionally, in total knee arthroplasty (TKA), it is aimed to keep the mechanical axis of the lower extremity neutral (mechanical alignment:3° varus-valgus in thecoronalplane) to improve long-term outcomes. This study aimed to assess the mid-term radiological and clinical results of patients with postoperative residual varus (more than 3° of varus) aftermechanically-aligned TKA. A total of 616 individuals who had undergoneTKAforprimaryknee osteoarthritisbetween 2008 and 2013 in our tertiary care hospital were retrospectively examined.All TKAs were performed with the mechanical alignment strategy.For radiological evaluation, hip-knee-ankle (HKA) angle, knee alignment angle (KAA), mechanical medial proximal tibial angle (mMPTA), knee inclination (KI), joint line orientation angle relative to ground (JLOA-G), posterior tibial slope (PS), joint line convergence angle (JLCA) were measured. Besides, patients' latest radiographs were screened for any clue of aseptic loosening or mechanical failure. Knee Society Score (KSS) (knee and functional subgroups), and Lysholm, Oxford, and Tegner scores were used for clinical evaluation. In addition, knee flexion and extension limitations were assessed. After applying the exclusion criteria, a minimum of five-year follow-up result of 110 patients was demonstrated.There were 101 females (92%) and nine males (8%). The mean follow-up time was 65.8 ± 6.3 months (range: 60.8-75.8 years). The mean age was 65.9 ± 7.7 years (range: 39 to 89 years). Thepreoperative mean mechanical axis angle of the lower extremity was17.3° ± 7.8° (range: 13.4-43.9°), whereas it was 8.3° ± 3.6° (range: 3.2-19.8°) postoperatively.The preoperative mean flexion angle was 90.7° ±23.8° (range: 40-130°), andthe extension limitation was -2.5° ± 7.4° (range: -40-0°), whereas, postoperatively, they were102.8° ± 15.4° (range from 40° to 150°) and -3.7° ± 7.5°(range from -40° to0°), respectively.The latest follow-up's mean KSS knee subgroup was 67 ± 18.4 (range: 12-93), the mean KSS functional subgroup was 74 ± 23.6 (range: 20-100), the mean Lysholm score was 81.7 ± 15.7 (range:25-100), the mean Tegner score was 3.65 ± 0.99 (range: 1-5), the mean Oxford score was 37.4 ± 6.5 (range: 9-48). There was no patient with aseptic loosening or mechanical failure. In the mid-term follow-up of patients with residual varus aftermechanically-alignedTKA, satisfactoryclinicaland radiological results were obtained without aseptic loosening or implant failure.

Sacrifice of Involved Nerve Root during Surgical Resection of Foraminal and/or Dumbbell Spinal Neurinomas.

Even if usually needed to achieve the gross total resection (GTR) of spinal benign nerve sheath tumors (NSTs), nerve root sacrifice remains controversial regarding the risk of neurological deficit. For foraminal NSTs, we hypothesize that the involved root is poorly functional and thus can be safely sacrificed. All spinal benign NSTs with foraminal extension that underwent surgery from 2013 to 2021 were reviewed. The impacts of preoperative clinical status and patient and tumor characteristics on long-term outcomes were analyzed. Twenty-six patients were included, with a mean follow-up (FU) of 22.4 months. Functional motor roots (C5-T1, L3-S1) were involved in 14 cases. The involved nerve root was routinely sacrificed during surgery and GTR was obtained in 84.6% of cases. In the functional root subgroup, for patients with a pre-existing deficit (n = 5/14), neurological aggravation persisted in one case at last FU (n = 1/5), whereas for those with no preop deficit (n = 9/14), a postoperative deficit persisted in one patient only (n = 1/9). Preoperative radicular pain was the only characteristic significantly associated with an immediate postoperative motor deficit (p = 0.03). The sacrifice of an involved nerve root in foraminal NSTs seems to represent a reasonable and relevant option to resect these tumors, permitting one to achieve tumor resection in an oncologic fashion with a high rate of GTR.

Difference in Perception of Nasal Aesthetic Appearance Between Surgeons and Rhinoplasty Patients: A Single-Center Perspective.

Patient satisfaction is an essential outcome measure after a rhinoplasty. Yet it is not known whether the opinions of rhinoplasty patients and surgeons on nasal aesthetic appearance differ. The aim of this study was to determine the differences between patients and surgeons in their perception of nasal aesthetic appearance. A retrospective cohort of 300 patients seen in consultation for cosmetic, functional, or combined cosmetic and functional rhinoplasty at a single tertiary care center from June 2017 to June 2020 was studied. Based on preoperative patient images, 6 surgeons with varying levels of expertise assessed nasal aesthetics utilizing a modified Standardized Cosmesis and Health Nasal Outcomes Survey for nasal cosmesis (SCHNOS-C). These scores were then compared to the patient-reported SCHNOS-C scores. The cosmetic, functional, and combined subgroups consisted of 100 patients each. The mean [standard deviation] age was 35.4 [13.7] years and 64% were women. The modified SCHNOS-C scores were well-correlated among the 6 surgeons but showed only weak correlations of 0.07 to 0.20 between patient-reported scores and scores assessed by the surgeons. Compared with the surgeon's scores, patients in the cosmetic subgroup perceived their nasal aesthetic problems to be more severe whereas the those in the functional subgroup perceived their nasal aesthetic problems to be milder compared with the surgeons' assessment. Our findings suggest that patients and surgeons perceive nasal cosmesis differently. This difference should be considered carefully when planning rhinoplasty or assessing its outcome.

Staying Apart to Work Better Together: Team Structure in Cross-Functional Teams

Organizations often leverage cross-functional teams to create innovative solutions and products, yet collaboration across functional boundaries is inherently challenging. Research on small teams largely suggests that, to facilitate team creative outcomes, subgroups should integrate across functional boundaries by increasing communication. In contrast, research on larger cross-functional teams (e.g., multiteam systems) suggests that too much communication across knowledge domains can worsen team outcomes. Using a quasi-experimental design, we investigate the influence of these two different team structures on cross-functional team communication and subsequent innovation outcomes. Contrary to the prevailing recommendation for an integrated team structure in small teams, results illustrate that integrating teams, and the resultant extensive cross-functional communication, does not enhance team innovation outcomes. Rather, teams with greater functional subgroup differentiation, though exhibiting relatively less cross-functional communication, exhibit greater cross-functional synthesis. These results suggest important implications for managers of cross-functional knowledge integration work as well as the future study of cross-functional teamwork of all sizes.

Subgroup analysis for functional partial linear regression model

AbstractIn a functional partial linear regression (FPLR) model, where the response variable is scalar while the explanatory variables involve both infinite‐dimensional functional predictors and finite‐dimensional scalar covariates, the relationships between the response and the explanatory variables are often assumed to be the same for all subjects. This article relaxes this assumption and considers a subgroup analysis for the FPLR model, which allows the intercepts to vary for different subgroups from a heterogeneous population. By projecting the functional predictors onto the corresponding eigenspace, the subgroup analysis based on the FPLR model can be simplified to a framework that is similar to the classical subgroup analysis problem. To automatically identify subgroups among observations and estimate the regression parameters of interest, we combine the functional principal component analysis with the concave pairwise penalized approach and develop an ADMM algorithm for functional subgroup analysis. We also establish the consistency of the proposed estimators under mild conditions. Simulation experiments demonstrate that the concave penalized subgroup approach could potentially achieve substantial gains over the ordinary FPLR model. The analysis of data from a creative achievement study is used to illustrate the practical performance of the subgroup analysis for the FPLR model.

Nusinersen efficacy data for 24-month in type 2 and 3 spinal muscular atrophy.

The study reports real world data in type 2 and 3 SMA patients treated for at least 2 years with nusinersen. Increase in motor function was observed after 12 months and during the second year. The magnitude of change was variable across age and functional subgroup, with the largest changes observed in young patients with higher function at baseline. When compared to natural history data, the difference between study cohort and untreated patients swas significant on both Hammersmith Functional Motor Scale and Revised Upper Limb Module both at 12 months and at 24 months.

608 The VCX Index: a novel haemodynamic quantification of mitral regurgitation

Abstract Percutaneous edge-to-edge mitral valve (MV) repair is extensively used in different pathological MV conditions. Randomized controlled trials have evaluated the role of this technique in both primary (organic) and secondary (functional) mitral regurgitation (MR). Furthermore, recent analyses of these studies have shown the relevance of echocardiographic patient selection in the functional setting of MR, differentiating proportionate MR from disproportionate MR according to the degree of the effective regurgitant orifice area (EROA) related to the left ventricular volume. The haemodynamic impact of MR cannot be univocally measured by echocardiography alone and the aim of our study was to determine how invasive LAP monitoring during percutaneous edge-to-edge MV repair can predict long-term procedural success on top of the echocardiographic assessment by introducing the VCX INDEX and identifying haemodynamic variables with direct influence on filling pressures. The VCX INDEX, reflecting the impact of MR, is calculated by dividing the difference between v wave (ventricular systole in the left atrial pressure, LAP, or in the pulmonary capillary wedge pressure, PCWP, waveform) and the mean minimum LAP or mean minimum PCWP (mean between minimum LAP or minimum PCWP, x wave, and a/c wave) by systolic arterial pressure (SAP): (v wave – mean minimum LAP or mean minimum PCWP)/SAP. 85 patients at our centres underwent invasive intracardiac pressure monitoring either measuring LAP during percutaneous edge-to-edge MV repair or PCWP during right heart catheterization. Median VCX INDEX was 0.1 (Q1 0.05, Q3 0.16). The study population was further analysed according to the echocardiographic aetiology of MR: in the organic MR subgroup median VCX INDEX was 0.08 (Q1 0.05, Q3 0.14), in the functional proportionate MR subgroup median VCX INDEX was 0.07 (Q1 0.03, Q3 0.13) and in the functional disproportionate MR subgroup median VCX INDEX was 0.11 (Q1 0.06, Q3 0.19). 20 patients were deemed inoperable by the Heart Team and no further intervention was performed, while 65 patients underwent percutaneous edge-to-edge MV repair with MitraClip device and VCX INDEX was recalculated after the procedure. Median post-MitraClip VCX INDEX was 0.04 (Q1 0.02, Q3 0.07) and a subanalysis based on the echocardiographic MR aetiology was repeated: median post-MitraClip VCX INDEX was 0.02 in the organic MR subgroup (Q1 0.01, Q3 0.05), 0.03 in the functional proportionate MR subgroup (Q1 0.02, Q3 0.07) and 0.05 in the functional disproportionate MR subgroup (Q1 0.03, Q3 0.07). Median VCX INDEX in patients who did not undergo MitraClip implantation was 0.07 (Q1 0.04, Q3 0.12). The variation of VCX INDEX when comparing pre- and post-procedural invasive pressure assessment gives an insight of MitraClip’s favourable haemodynamic effect in terms of VCX INDEX reduction in the treated subgroup of the study and how the intervention has a comparable haemodynamic impact between different echocardiographic MR aetiologies. Further studies are needed to explore the incremental diagnostic role in the decision-making process as well as the prognostic value of the VCX INDEX in patients undergoing percutaneous edge-to-edge MV repair.

Patterns of taxonomic and functional diversity in the global cleaner reef fish fauna

AbstractAimSeveral drivers explain the global distribution of all reef fish. However, whether these drivers also explain the distribution and traits of a functional subgroup involving cleaner fishes remain unclear. Here we examine the variation in traits of cleaner fishes and test whether historical, environmental, ecological and geographical drivers are correlated with cleaner species richness and abundance at global reefs.LocationTropical and subtropical reefs.TaxonActinopterygii.MethodsWe tested whether species traits and trait space vary between facultative (i.e. species that clean only during the juvenile stages or sporadically) and dedicated (i.e. species that clean during their whole lives) cleaner types. We compiled data from local checklists (relative richness) and belt transects (standardized richness and abundance). We built four models to test whether past and current isolation (i.e. distance from Quaternary refugia and biodiversity centres), sea temperature, primary productivity, local species pool and abundance of potential clients influenced the relative richness and abundance of cleaners.ResultsFacultative cleaners had high trait variability that contributed disproportionally to the trait space, whereas dedicated cleaners exhibited low trait variability. Cleaner species richness was higher in the Indo‐Pacific and Caribbean provinces, but the relative richness and standardized abundance of cleaners were higher in the Atlantic (i.e. North Eastern and Southwestern) and Eastern Pacific. Isolation influenced the relative richness of facultative cleaners, whereas the distance to Quaternary refugia, sea temperature and isolation influenced the relative richness of dedicated cleaners. Local species richness and standardized abundance of cleaner fish exhibited a strong relationship with regional diversity. The standardized abundance of both facultative and dedicated cleaners was influenced by the abundance of potential clients and the local species pool.Main conclusionsThe small trait space occupied by cleaner fishes may reflect their restricted origin among lineages of reef fishes. Differences in the relative richness and standardized abundance of cleaner fishes across marine realms suggest a strong influence on biogeographical history. Our results also indicate that cleaner fishes originated mostly in peripheral areas in high latitudes due to the absence of dedicated cleaners. Our results imply that cleaner fishes do not follow the pattern of main centres of origin described for reef fishes due to opportunistic cleaning behaviour that originated with higher frequency at locations with low species richness.

Impact of iron deficiency on prognosis of heart failure patients with preserved ejection fraction

Objective: To investigate the impact of iron deficiency (ID) on prognosis in heart failure patients with preserved ejection fraction (HFpEF). Methods: A total of 215 consecutive patients with HFpEF, who visited the cardiovascular outpatient department of Beijing Anzhen Hospital, were enrolled in this prospective study. The plasma ferritin level and transferin saturation were measured. Patients were divided into two groups: ID group and non-ID group. ID patients were further divided into absolute ID subgroup and functional ID subgroup. Patients were followed up to 1 year. The endpoints of the study were all-cause mortality and rehospitalization for heart failure (HF). The independent predictors of outcome were determined by Cox regression model. The quality of life of patients was evaluated at the end of the follow-up. Results: The age of this patient cohort was (67±8) years, 39.1% patients were male. The prevalence of ID was 54.4%. Within one year of follow-up, 37 patients (17.2%) died and 70 patients (32.6%) were rehospitalized for HF. Compared to non-ID group, patients in ID group were older, had higher heart rate, lower plasma hemoglobin level and estimated glomerular filtration rate (eGFR) value, had a higher prevalence of anemia and chronic kidney disease (P all<0.05). Kaplan-Meier curves showed that all-cause mortality and rehospitalization for HF in HFpEF patients with ID were higher than patients without ID, and prognosis was similar between patients with absolute ID and functional ID. Multivariable regression analysis showed that ID was an independent predictor for all-cause mortality and rehospitalization for HF in HFpEF patients. The of 6 minutes walking distance was shorter ((356.0±98.3)m vs. (389.2±94.3)m, P=0.023), and the value in Kansas city cardiomyopathy questionnaire was lower ((58.06±10.43) m vs. (61.51±11.64) m, P = 0.039) in patients with ID than patients without ID. Conclusion: In patients with chronic HFpEF, ID is an independent predictor for all-cause mortality and rehospitalization for HF at one year of follow-up, independent of the types of ID.

Emotional regulation in eating disorders and gambling disorder: A transdiagnostic approach.

Background and aimsDifficulties in Emotion Regulation (ER) are related to the etiology and maintenance of several psychological disorders, including Eating Disorders (ED) and Gambling Disorder (GD). This study explored the existence of latent empirical groups between both disorders, based on ER difficulties and considering a set of indicators of personality traits, the severity of the disorder, and psychopathological distress.MethodsThe sample included 1,288 female and male participants, diagnosed with ED (n = 906) and GD (n = 382). Two-step clustering was used for the empirical classification, while analysis of variance and chi-square tests were used for the comparison between the latent groups.ResultsThree empirical groups were identified, from the most disturbed ER profile (Subgroup 1) to the most functional (Subgroup 3). The ER state showed a linear relationship with the severity of each disorder and the psychopathological state. Different personality traits were found to be related to the level of emotion dysregulation.Discussion and conclusionIn this study, three distinct empirical groups based on ER were identified across ED and GD, suggesting that ER is a transdiagnostic construct. These findings may lead to the development of common treatment strategies and more tailored approaches.

Coexpressed Genes That Promote the Infiltration of M2 Macrophages in Melanoma Can Evaluate the Prognosis and Immunotherapy Outcome.

Purpose To improve immunotherapy efficacy for melanoma, a coexpression network and key genes of M2 macrophages in melanoma were explored. A prognostic risk assessment model was established for M2-related coexpressed genes, and the role of M2 macrophages in the immune microenvironment of melanoma was elucidated. Method We obtained mRNA data from melanoma and peritumor tissue samples from The Cancer Genome Atlas-skin cutaneous melanoma (TCGA-SKCM). Then, we used CIBERSORT to calculate the proportion of M2 macrophage cells. A coexpression module most related to M2 macrophages in TCGA-SKCM was determined by analyzing the weighted gene coexpression network, and a coexpression network was established. After survival analysis, factors with significant results were incorporated into a Cox regression analysis to establish a model. The model's essential genes were analyzed using functional enrichment, GSEA, and subgroup and total carcinoma. Finally, external datasets GSE65904 and GSE78220 were used to verify the prognostic risk model. Results The yellow-green module was the coexpression module most related to M2 macrophages in TCGA-SKCM; NOTCH3, DBN1, KDELC2, and STAB1 were identified as the essential genes that promoted the infiltration of M2 macrophages in melanoma. These genes are concentrated in antigen treatment and presentation, chemokine, cytokine, the T cell receptor pathway, and the IFN-γ pathway. These factors were analyzed for survival, and factors with significant results were included in a Cox regression analysis. According to the methods, a model related to M2-TAM coexpressed gene was established, and the formula was risk score = 0.25∗NOTCH3 + 0.008∗ DBN1 − 0.031∗KDELC2 − 0.032∗STAB1. The new model was used to perform subgroup evaluation and external queue validation. The results showed good prognostic ability. Conclusion We proposed a Cox proportional hazards regression model associated with coexpression genes of melanoma M2 macrophages that may provide a measurement method for generating prognosis scores in patients with melanoma. Four genes coexpressed with M2 macrophages were associated with high levels of infiltration of M2 macrophages. Our findings may provide significant candidate biomarkers for the treatment and monitoring of melanoma.

Examining Preoperative Expectations and Postoperative Satisfaction in Rhinoplasty Patients: A Single-Center Study.

Background: In Rhinoplasty, understanding patient expectations are pivotal in achieving an optimal surgical outcome. Objective: To understand preoperative expectations and postoperative satisfaction in patients undergoing rhinoplasty for functional, aesthetic, or both. Method: Adult patients undergoing functional, aesthetic, or combined rhinoplasty from March 2017 to June 2019 were prospectively enrolled. Only patients with complete preoperative functional and cosmetic expectation visual analog scales (VAS) and at least one postoperative functional and cosmetic satisfaction VAS were included. Nasal Obstruction and Symptom Evaluation Scale score and Standardized Cosmesis and Health Nasal Outcomes Survey score were also collected. Results: In the functional subgroup (mean preoperative functional expectation VAS score [17.98 (22.49)] higher mean (standard deviation) postoperative functional satisfaction VAS score were observed at postoperative time interval <2 months [29.59 (27.08), p = 0.008] and 8-12 months [31.43 (28.25), p = 0.035]. In the aesthetic subgroup mean preoperative cosmetic expectation VAS score [89.69 (17.74)], lower mean postoperative aesthetic satisfaction VAS scores were observed at <2 months [79.09 (20.01), p = 0.0001], 2-5 months [79.79 (20.79), p = 0.032], 5-8 months [72 (18.27), p < 0.0001], 8-12 months [78.15 (24.50), p = 0.021], and >12 months [75 (20.64), p = 0.00020]. In the combined subgroup (mean preoperative aesthetic expectation VAS score [85.85 (18.19)]), lower mean postoperative aesthetic satisfaction VAS scores were observed at 2-5 months [78.94 (20.88), p = 0.01] and at >12 months [75.86 (25.57), p = 0.01]. Conclusion: Although rhinoplasty patients tend to be less satisfied with aesthetic than the functional outcome of surgery, preoperative aesthetic expectations are higher in cosmetic rhinoplasty and functional and cosmetic rhinoplasty patients.

Natural History of the Standardized Cosmesis and Health Nasal Outcomes Survey After Rhinoplasty.

To explore the natural history of nasal obstruction and cosmesis following rhinoplasty by utilizing the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS). Retrospective chart study. This study was carried out at a tertiary referral center, preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE), SCHNOS-Obstruction (SCHNOS-O), and SCHNOS-Cosmesis (SCHNOS-C) scores in patients who underwent rhinoplasty for functional, cosmetic, or both reasons from June 2017 to May 2019 were reviewed and analyzed. Postoperative intervals were defined as <2 months, 2 to 5 months, 5 to 8 months, 8 to 12 months, and >12 months. A total of 302 patients (67% women), with a mean age (standard deviation [SD]) of 35 (13) years, who underwent rhinoplasty for functional (90, 30%), cosmetic (124, 41%), and combined functional and cosmetic (88, 29%) reasons, met inclusion criteria. The mean follow-up period (SD, range) was 5 months (4.2 months, 13 days-1.8 years). Compared to the preoperative mean NOSE score, SCHNOS- O, and SCHNOS-C scores, postoperative mean scores for the functional and combined subgroup were significantly lower (P < .05) across all five postoperative intervals. In the cosmetic subgroup, postoperative mean SCHNOS-C scores were significantly lower (P < .05) across all postoperative intervals compared to the mean preoperative scores. The natural history of the SCHNOS-O and SCHNOS-C score in patients who underwent rhinoplasty demonstrates 1) after functional rhinoplasty, an improvement in nasal breathing symptoms is attained as early as <2 months postoperatively; and 2) after cosmetic rhinoplasty, an improvement in nasal cosmesis is seen as early as <2 months postoperatively. These improvements in nasal breathing and cosmesis are sustained through a follow-up interval >12 months. 4 Laryngoscope, 131:E116-E123, 2021.

Improved Functional Outcomes Following Operative Treatment of Midshaft Clavicle Fractures in an Active Duty Population

Clavicle fractures are common orthopedic injuries that occur in a young active population and are even more common in the military. Military fitness test data presents the unique opportunity to analyze functional ability with regard to military-specific activities. The primary goal of this study was to compare functional outcomes using military fitness test data between operative and non-operative treatment of midshaft clavicle fractures. We performed a retrospective review of active-duty U.S. Navy and Marine patients with midshaft clavicle fractures treated at our institution over a seven-year period. There were 94 and 153 patients in our operative and non-operative cohorts, respectively. Average follow-up time from the date of injury or surgery was 28 months.The rate of infection in the operative group (4%) was significantly greater than in the non-operative group (0%, p = 0.023). The rate of non-union in the operative group (3%) was significantly lower than in the non-operative group (14.5%, p = 0.004). The rate of symptomatic malunion in the operative group (0%) was significantly different from that in the non-operative group (4.6%, p = 0.036). There was no significant difference in the rate of revision surgery between the operative (9.2%) and non-operative (13.2%) groups (p = 0.105).A total of 51 marines met inclusion criteria for our functional outcome analysis using Marine Corps Physical Fitness Test (PFT) data. Of those who underwent operative fixation, 68% were able to meet or surpass their pre-injury average amount of pull-ups in their first PFT after surgery and 88% by the next PFT at least one year after surgery. While 69% of non-operative patients met their pre-injury average in their first PFT, only 57% maintained this level at least one year after surgery. This difference was statistically significant.In our functional outcome subgroup analysis, we found improved outcomes for pull-ups at least one year out when midshaft clavicle fractures are treated operatively compared to non-operatively. While similar findings in the literature are based on functional outcome questionnaires, physical fitness performance data has not been reported on to our knowledge.

T Helper 9 Cells: A New Player in Immune-Related Diseases.

The helper T cell 9 (Thelper-9, Th9), as a functional subgroup of CD4+T cells, was first discovered in 2008. Th9 cells expressed transcription factor PU.1 and cytokine interleukin-9 (IL-9) characteristically. Recent researches have shown that the differentiation of Th9 cells was coregulated by cytokine transforming growth factor β, IL-4, and various transcription factors. Th9 cells, as a new player, played an important role in various immune-related diseases, including tumors, inflammatory diseases, parasite infection, and other diseases. In this article, we summarize the related research progress and discuss the possible prospect.

Can We Predict Failure of Mitral Valve Repair?

Objective: To identify echocardiographic and surgical risk factors for failure after mitral valve repair. Methods: We identified a total of 77 consecutive patients from our institutional mitral valve surgery database who required redo mitral valve surgery due to recurrence of mitral regurgitation after primary mitral valve repair. A control group of 138 patients who had a stable echocardiographic long-term result was included based on propensity score matching. Systematic analysis of echocardiographic parameters was performed before primary surgery; after mitral valve repair and prior to redo surgery. Risk factor analysis was performed using multivariate Cox regression model. Results: Redo surgery was associated with the presence of pulmonary hypertension ≥ 50 mmHg (p = 0.02), a mean transmitral gradient > 5 mmHg (p = 0.001), left ventricular ejection fraction ≤ 45% (p = 0.05) before surgery and mitral regurgitation ≥moderate at time of discharge (p = 0.002) in the whole cohort. Patients with functional mitral valve regurgitation had a higher tendency to undergo redo surgery if preoperative left ventricular end-diastolic diameter exceeded 65 mm (p = 0.043) and if postoperative tenting height exceeded 6 mm (p = 0.018). Low ejection fraction was not significantly associated with the need for redo mitral valve surgery in the functional subgroup. Conclusions: Recurrent mitral regurgitation is still a valuable problem and is associated with relevant perioperative mortality. Patients with severe mitral regurgitation should undergo early mitral valve repair surgery as long as systolic pulmonary artery pressure is low, left ventricular ejection fraction is preserved, and LVEED is deceeds 65 mm.